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IG
Insight Global
Insurance Verificiation Specialist
Career Insights for Eligibility Specialist
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Scorecard
Based on New Jersey data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$51,009 / year median in New Jersey
+24% projected growth
Job Description
Required Skills & Experience
- 2+ years of health insurance verification experience in a healthcare, medical office, revenue cycle, or patient access environment.
- Strong understanding of medical terminology and insurance benefit verification processes.
- Experience using payer portals and/or contacting insurance carriers directly to confirm eligibility, benefits, and coverage details.
- Ability to clearly document insurance information and communicate issues to patients, clinics, and internal departments.
- Strong attention to detail, organization, follow-through, and ability to manage high-volume work queues.
- Reliable attendance, strong professionalism, and comfort working onsite as part of a small local team. Nice to Have Skills & Experience
- Bilingual in Spanish
- Experience with EMR systems and insurance verification dashboards or spreadsheet-based work queues.
- Prior experience supporting surgical, specialty care, plastic surgery, orthopedics, workers' compensation, or motor vehicle-related claims.
- Ability or interest in cross-training into prior authorization.
- Experience working with offshore or third-party verification vendors.
- Review daily insurance verification work queues and exception reports from spreadsheets, dashboards, and vendor-supported workflows.
- Use insurance portals, payer websites, and direct carrier outreach to verify patient insurance eligibility, benefits, coverage details, and missing information.
- Contact patients by phone, email, or follow up on system-generated messages when updated insurance cards, policy details, or additional information are needed.
- Communicate with insurance carriers, workers' compensation contacts, and motor vehicle adjusters to gather accurate coverage information when applicable.
- Document verification details clearly in the EMR system so clinics, collectors, surgical coordinators, and other internal teams can reference accurate information.
- Identify inactive policies, referral needs, benefit issues, or other insurance-related concerns and proactively communicate them to the appropriate teams.
- Support verification needs across the full practice rather than one specific provider, averaging approximately 30 patient verifications per day.
- Collaborate with the local Insurance Verification team and help cover shared work when teammates are out or volume shifts.
Compensation:
$20 to $23 per hour.Benefits:
- Medical, Dental, Vision, Life, HSA and Long-Term Disability insurance
- 401k and Profit sharing
- Paid Time Off
- Contribution to Health Benefits
- Company Discounts on
Products & Services Pay:
$51,058.95- $61,490.